Adventist Midwest Health offers the latest innovative treatments to fight cancer: intensive modulated radiation therapy (IMRT), which has the ability to shape and target radiation beams directly to the tumor and spare healthy tissue, and image-guided radiation therapy (IGRT), which uses a small piece of metal as a marker to guide machines – linear accelerators – that deliver the beams.
“Ever since the turn-of-the-century discovery of X-ray therapy to treat cancers, a constant evolution has occurred because of improved technology,” says Brian Moran, MD, medical director of the oncology department with Adventist Midwest Health. “IGRT is just the next phase of IMRT. As doctors, we are committed to keeping up with the latest technology, so we know how to use it.”
Historically, only limited amounts of radiation could be delivered to a tumor without adversely affecting healthy tissue. But with the advent of IMRT, a CT scan or MRI produces a clear, three-dimensional picture of the tumor and stores the image into a computer. This gives the linear accelerators the knowledge of the optimal amount of radiation to use and the exact location to send it.
Yet IMRT has one drawback: It cannot adjust for movement, which hinders the amount of radiation that can be given to certain tumors, such as those in the lungs and pelvis area.
“Because the patient is breathing, the lungs are going up and down,” Dr. Moran says. “In the pelvis, the bladder fills with urine and the rectum may have gas in it. But when you can compensate for the movement, you can deliver a higher dose of radiation, which will translate into a higher cure rate.”
Dr. Moran stresses that IGRT does not replace IMRT; it merely enhances its use. In some cases, IMRT alone is adequate therapy.
“There is no beneficial purpose in putting a marker in a patient who doesn’t need it,” Dr. Moran says. “You have to properly select the patients and not abuse the technology. Radiation therapy is an excellent way to treat cancer. But the only way to really know which therapy is best is to be evaluated by one of the radiation oncologists.”